The essential goal of the proposed Tropical Medicine Center is to improve the health of populations, especially those in neglected tropical disease-endemic regions of the world, by undertaking and promoting interdisciplinary research excellence. Its specific objectives include: i) the promotion and conduct of high quality basic, clinical and epidemiological research in tropical medicine; ii) engagement in collaborative research with local, national and international researchers; and iii) commitment to the training and mentoring of students and junior investigators. The first concrete examples of this mission and objectives are illustrated in the three proposed research projects which focus on three diseases causing the highest burden of disease among the neglected tropical diseases, i.e., the soil-transmitted helminthiases of ascariasis, hookworm disease and trichuriasis. These diseases are highly endemic in the Amazon region of Peru where the proposed Tropical Medicine Center will be situated. Each research project addresses important research gaps in a high-risk group (i.e., preschool-age children, school-age children and women of reproductive age) such that results will be able to be used immediately by global agencies like the World Health Organization and national authorities (and their partners) to inform health policy and intervention strategy on deworming. Ultimately, this research will contribute to reducing the morbidity, mortality and disability caused by the soil-transmitted helminthiases which currently are estimated to affect two billion people living in resource-poor communities around the world. RELEVANCE: The proposed Tropical Medicine Center will be based in the Amazon region of Peru and will be a center of research excellence in basic, clinical and epidemiological research focusing on neglected tropical diseases. Because of the high burden of disease caused by the soil-transmitted helminthiases, this cluster of diseases will constitute the inaugural research focus of the new Center. Project 1: Improving Childhood Growth and Development in Resource-Poor LMICs with Deworming by Incorporating Deworming in Integrated Child Health Care Project Leader (PL): Casapia, M. DESCRIPTION (provided by applicant): Preschool-age children are one of the three high risk groups for morbidity attributable to soil-transmitted helminth infections (STH). At this age, the STH infections of most importance are Ascaris and Trichuris infections. WHO recommends deworming of preschool-age children as of 12 months of age, but there is no empirical evidence on what deworming exposure (in terms of age at administration and frequency of administration) has the most beneficial impact on health. This research project therefore proposes to follow a cohort of preschool-age children who are known to have had different deworming exposure histories between 12 and 24 months of age. By following these children up to five years of age, cumulative health benefits will be measured and the optimal deworming strategy identified. It is expected that these health benefits will extend into later childhood and beyond. Research results will also be used to inform deworming health policy and strategies in STH-endemic regions globally. RELEVANCE: An important window of opportunity exists between 12 and 24 months of age when health and nutrition interventions play a vital role in both short and long term health. It is important to measure this health impact, not only because it fills a research gap, but also because it is useful feedback for program managers, and other partners. In following children up to five years of age, this cohort study will provide key empirical evidence on the health impact of different deworming strategies targeted to this high risk age.